Porokeratosis of Mibelli Treated With Topical 2% Lovastatin/2% Cholesterol Ointment

Porokeratosis is characterized by disruptions in the isoprenoid pathway, leading to the development of cornoid lamella, a unique skin lesion consisting of parakeratotic cells. The condition has a genetic foundation involving mutations affecting cholesterol synthesis, and new treatments aim to address these metabolic disruptions. This study examines a 56-year-old male with porokeratosis of Mibelli (PM) who presented with a non-healing erosion on his finger that persisted for two years. Previous therapies, including corticosteroids, antibiotics, and tacrolimus, proved ineffective. The patient then received a novel treatment with a topical 2% lovastatin/2% cholesterol ointment. After nine months, there was significant clinical improvement; the lesion was markedly reduced in size and appearance. This case underscores the potential of lovastatin/cholesterol ointment as an effective treatment for PM, indicating its promise for broader therapeutic applications.